GROWING UP TOBACCO FREE -- Copyright -- PREFACE -- REFERENCES -- ACKNOWLEDGMENTS -- Contents -- 1 TOWARD A YOUTH-CENTERED PREVENTION POLICY -- THE NEED FOR A YOUTH-CENTERED TOBACCO CONTROL POLICY -- Tobacco Use: Addictive and Mostly Initiated During Childhood and Adolescence -- Tobacco Use by Children and Youths: No Longer Declining -- The Emerging Public Health Consensus -- Public Support for a Youth-Centered Tobacco Control Policy -- Ethical Foundation of a Youth-Centered Tobacco Control Policy -- THE ELEMENTS OF A YOUTH-CENTERED TOBACCO CONTROL POLICY -- Actions That Should Be Taken Immediately -- Actions Required To Sustain Progress in the Long-Term -- REFERENCES -- 2 THE NATURE OF NICOTINE ADDICTION -- GENERAL ASPECTS OF NICOTINE ADDICTION -- The Daily Nicotine Addiction Cycle -- What Is Addiction? -- Pharmacologic Aspects of Nicotine -- Actions of Nicotine on the Brain -- Tolerance and Withdrawal -- Absorption of Nicotine from Tobacco -- Distribution and Elimination of Nicotine from the Body -- Intake and Accumulation of Nicotine During Cigarette Smoking -- Addiction and the Light or Occasional Smoker -- Nicotine Compensation -- The "Low-Yield" Cigarette -- Smoking Fewer Cigarettes -- Behavioral Aspects of Addiction -- Addiction to Smokeless Tobacco -- Comparison of Nicotine Addiction with Other Drug Addictions -- NICOTINE DEPENDENCY IN YOUTHS -- Epidemiology and Natural History of Cigarette Smoking -- Evidence for Nicotine Dependence in Youths -- Risk Factors for Smoking Initiation -- Ethnic Differences in Nicotine Dependency -- Use of Smokeless Tobacco by Children and Youths -- NATURE OF TOBACCO PRODUCTS -- Production of Tobacco Products -- Modifying Cigarette Yields -- CONCLUSIONS AND RESEARCH RECOMMENDATIONS -- REFERENCES -- 3 SOCIAL NORMS AND THE ACCEPTABILITY OF TOBACCO USE -- THE FUNCTION OF SOCIAL NORMS.

THE EMERGING TOBACCO-FREE NORM -- The Decline of Tobacco Use -- The Social Unacceptability of Tobacco Use -- TOBACCO USE AS PERCEIVED BY CHILDREN AND YOUTHS -- The Perception of Tobacco Use -- Spreading a False Impression: The Ubiquitous Pro-Tobacco Message -- OPPORTUNITIES FOR PROMOTING A TOBACCO-FREE NORM -- Families -- Peer Context -- The School Environment -- The Community Environment -- The Workplace -- Fast-Food Restaurants -- Shopping Malls -- Sports Facilities -- Community and Youth Organizations -- ADVOCACY FOR A TOBACCO-FREE NORM -- REINFORCING THE TOBACCO-FREE NORM: CONCLUSIONS AND RECOMMENDATIONS -- REFERENCES -- 4 TOBACCO ADVERTISING AND PROMOTION -- INTRODUCTION: MAINTAINING THE MARKET -- SHIFTING TRENDS IN TOBACCO MARKETING -- Promoting Tobacco Use to Consumers -- Inhibiting Opposition to Tobacco Use -- THE TOBACCO MARKET AND MARKET SEGMENTATION -- Tobacco: A Mature and a Growth Market -- Market Segmentation to Reach Youths -- THE APPEAL OF TOBACCO ADS TO CHILDREN AND YOUTHS -- Psychosocial Mechanisms Through Which Advertising Influences the Behavior of Children and Youths -- Themes and Images -- CRITICAL ASSESSMENT OF STUDIES ON ADVERTISING RECALL, ADVERTISING EXPENDITURES, AND TOBACCO CONSUMPTION -- Studies of Advertising Recall -- Econometric Studies of the Relationship Between Advertising and Consumption -- Studies of the Effects of Advertising Bans -- RATIONALE FOR RESTRICTIONS -- RECOMMENDATIONS -- Policy Recommendations -- Research Recommendations -- REFERENCES -- 5 PREVENTION AND CESSATION OF TOBACCO USE RESEARCH-BASED PROGRAMS -- PREVENTION OF SMOKING -- School-Based Smoking Prevention Research -- Approaches to School-Based Prevention Research -- Effectiveness of School-Based Smoking Prevention Programs -- Community-wide Programs to Prevent Smoking -- Summary Points -- PREVENTION OF SMOKELESS TOBACCO USE.

Unique Aspects of Smokeless Tobacco Use -- Evaluation of SLT Prevention Programs -- School-Based Programs -- Non-School-Based Programs -- Summary Points -- ADOLESCENT CESSATION OF SMOKING -- Data on Smoking Cessation -- Cessation Intervention Programs -- Cessation Interventions in Schools -- Non-School-Based Interventions -- Intervention Program Concepts -- Summary Points -- CESSATION OF SMOKELESS TOBACCO USE -- Desire to Quit Using Smokeless Tobacco -- Studies of Cessation of Smokeless Tobacco Use -- Studies of Users Recruited from Schools -- Self-Help Program -- Nicotine Replacement Therapy -- Clinic-Based Interventions -- Co-use of SLT and Cigarettes -- Summary Points -- RECOMMENDATIONS -- REFERENCES -- 6 TOBACCO TAXATION IN THE UNITED STATES -- TOBACCO TAXES IN THE UNITED STATES -- Federal Tobacco Taxes -- State and Local Tobacco Taxes -- Trends in Cigarette Prices, Taxes, and Affordability -- Trends in Cigarette Tax Revenues and Sales -- TAX RATES IN OTHER INDUSTRIALIZED COUNTRIES -- EFFECT OF EXCISE TAXES ON CONSUMPTION -- The Canadian Experience -- Adolescents' Sensitivity to Price -- ARGUMENTS FOR AND AGAINST HIGHER TOBACCO TAXES -- CONCLUSIONS AND RECOMMENDATIONS -- REFERENCES -- 7 YOUTH ACCESS TO TOBACCO PRODUCTS -- BACKGROUND OF YOUTH ACCESS MEASURES -- A Brief History of the Emergence of Youth Access Measures -- Lack of Enforcement -- RECENT INITIATIVES -- Local Initiatives -- The Role of DHHS and the Model Law -- The Synar Amendment and Regulations -- THE BENEFITS OF REDUCING ACCESS -- DESIGNING A YOUTH ACCESS POLICY -- Intergovernmental Roles -- Essential Components of a Reduced Access Plan -- Implement a Retailer Licensing System -- Ban Tobacco Vending Machines -- Restrict Methods of Sale -- Ban Free Distribution -- Foster Community Action to Monitor and Encourage Compliance -- Actively Enforce Youth Access Legislation.

Additional Considerations to Guide Youth Access Legislation -- SUGGESTIONS FOR ADDITIONAL POLICY INITIATIVES AND RESEARCH -- Further Initiatives -- Tobacco-Free Zones Near Schools -- Bans on Pharmacy Sales -- Restrict Mail-Order Distribution -- Additional Research Needed -- REFERENCES -- 8 REGULATION OF THE LABELING, PACKAGING, AND CONTENTS OF TOBACCO PRODUCTS -- TOBACCO: AN UNREGULATED HAZARD -- WARNINGS AND PACKAGING -- The History of Federal Action -- The Importance of Warnings in Discouraging Use by Youths -- The Inadequacy of Existing Warnings -- Recent Initiatives in Other Countries -- Recommendations for Health Warnings and Packaging of Tobacco Products -- REGULATION OF CONSTITUENTS OF TOBACCO PRODUCTS -- A Unique Regulatory Challenge -- The Regulatory Agency -- Possible Regulatory Initiatives -- REFERENCES -- 9 COORDINATION OF POLICIES AND RESEARCH -- THE ROLE OF THE FEDERAL GOVERNMENT -- Leadership -- Regulation of the Tobacco Industry -- Monitoring Public Health and Providing Technical Assistance to States -- Support of Research -- A Multicultural Research Agenda -- A Youth-Centered Research Agenda -- A Policy-Oriented Research Agenda -- Services -- THE ROLE OF STATE AND LOCAL GOVERNMENTS -- THE ROLE OF PRIVATE SECTOR ORGANIZATIONS -- LINKAGE BETWEEN EXCISE TAX REVENUES AND TOBACCO CONTROL PROGRAM FUNDING -- OPTIONS AND RECOMMENDATIONS FOR COORDINATION -- EPILOGUE -- REFERENCES -- APPENDIXES -- A SPECIFIC RECOMMENDATIONS, BY CHAPTER -- Chapter 2: The Nature of Nicotine Addiction -- Chapter 3: Social Norms and the Acceptability of Tobacco -- Chapter 4: Tobacco Advertising and Promotion -- Chapter 5: Prevention and Cessation of Tobacco Use: Research-Based Programs -- Chapter 6: Tobacco Taxation in the United States -- Chapter 7: Youth Access to Tobacco -- Chapter 8: Regulation of the Labeling, Packaging, and Contents of Tobacco Products.

Chapter 9: Coordination of Policies and Research -- B COMMITTEE BIOGRAPHIES -- INDEX.